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Article(id=1323941314928194512, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202501232, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736697600000, receivedDateStr=2025-01-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793581807118, onlineDateStr=2026-11-02, pubDate=1765296000000, pubDateStr=2025-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793581807118, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793581807118, creator=13701087609, updateTime=1793581807118, updator=13701087609, issue=Issue{id=1323941237702668764, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='23', pageStart='4225', pageEnd='4416', issueExtLink='null', onlineDate='null', pubDate='1765296000000', pubDateStr='2025-12-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793581788707, creator='13701087609', updateTime=1793581887795, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1323941653374959780, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1323941653374959781, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=4310, endPage=4314, ext={EN=ArticleExt(id=1323941315280516049, articleId=1323941314928194512, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between weight-specific handgrip strength and metabolic syndrome in children and adolescents, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between weight-specific handgrip strength (Wt-HGS) and metabolic syndrome(MetS) and its components, providing new evidence for metabolic risk assessment in children and adolescents.

Methods

Data were derived from the 2021 Evaluation and Monitoring of School-based Nutrition and Growth in Shenzhen (EMSNGS) study. Based on handgrip strength percentile reference standards, handgrip strength was categorized into quartiles (Q1-Q4) using both age-specific(Age-HGS) and weight-specific (Wt-HGS) percentiles, with Q1 defined as the low handgrip strength group. The prevalence of MetS and its components was compared between the low handgrip strength groups based on the two standards.

Results

A total of 3 272 children and adolescents aged 10-18 years were included in the study, with a median age of 13.8 (11.9, 15.6) years and a MetS prevalence of 3.9% (n=129). The prevalence of MetS was significantly higher in the low handgrip strength group defined by Wt-HGS than in that defined by Age-HGS (boys: 9.4% vs 2.6%; girls: 5.9% vs 1.4%). Logistic regression analysis revealed that, compared to the highest quartile of Wt-HGS (Q4), the odds ratio (OR) for MetS risk in boys in the Q1 group was 5.26 (95% CI: 2.55-10.85), and for girls, the risk was even higher (OR=11.91, 95% CI: 2.78-51.04). After adjusting for age, puberty stage, and other potential confounders, the association remained statistically significant.

Conclusion

Lower Wt-HGS may be a risk factor for MetS in children and adolescents, highlighting the potential value of muscle strength assessment and targeted interventions in the early prevention and control of MetS.

, authors=Yong-fang SONG1, 2, Zhuo-guang LI1, Rong-fei ZHENG1, Xiu ZHAO1, Chu-shan WU1, Run-ting XIAO1, Qi-ru SU3, Jing-fan XIONG4, Zhe SU1, authorsList=Yong-fang SONG, Zhuo-guang LI, Rong-fei ZHENG, Xiu ZHAO, Chu-shan WU, Run-ting XIAO, Qi-ru SU, Jing-fan XIONG, Zhe SU, authorCompany=null, correspAuthors=Zhe SU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1323941318057145302, articleId=1323941314928194512, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=儿童青少年体重别握力与代谢综合征的关联性分析, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探讨体重别握力（weight-specific handgrip strength, Wt-HGS）与代谢综合征（metabolic syndrome, MetS）及其组分的关系，为儿童青少年代谢风险评估提供新的依据。

方法

数据来源于2021年深圳市中小学生营养健康与生长发育评估与监测项目。依据握力百分位参考标准，将握力按年龄别握力（age-specific handgrip strength, Age-HGS）和Wt-HGS分为四分位（Q1～Q4），其中Q1定义为低握力组。比较两种标准下低握力儿童的MetS及其组分患病率差异。

结果

研究共纳入3 272名10～18岁儿童青少年，中位年龄为13.8（11.9,15.6）岁，MetS患病率为3.9%（n=129）。基于Wt-HGS标准划分的低握力组，其MetS患病率显著高于Age-HGS标准组（男童9.4% vs. 2.6%；女童5.9% vs. 1.4%）。Logistic回归分析显示，以Wt-HGS最高四分位（Q4）为参照，男童Q1组的MetS患病风险显著增加（OR=5.26，95% CI: 2.55～10.85），女童风险更高（OR=11.91，95% CI: 2.78～51.04）；在调整年龄、青春发育分期等潜在混杂因素后，该关联仍显著存在。

结论

较低的Wt-HGS水平可能是儿童青少年MetS的危险因素，提示加强肌力评估与干预措施，可能有助于MetS的早期防控。

, authors=宋永芳1, 2, 李卓光1, 郑荣飞1, 赵岫1, 吴楚姗1, 肖润廷1, 苏琪茹3, 熊静帆4, 苏喆1, authorsList=宋永芳, 李卓光, 郑荣飞, 赵岫, 吴楚姗, 肖润廷, 苏琪茹, 熊静帆, 苏喆, authorCompany=null, correspAuthors=苏喆, authorNote=

宋永芳与李卓光为共同第一作者

宋永芳（1983—），女，硕士，副主任医师，研究方向：儿童内分泌疾病；

李卓光（1993—），男，博士，主治医师，研究方向：儿童内分泌遗传罕见病；

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苏喆，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=s50ZDpqdfzy9BNNp7BMPeA==, magXml=d4drz+/Uw+zBH6921RBdWQ==, pdfUrl=null, pdf=DjGzvjMQ5MFZk13E+Ts7Lw==, pdfFileSize=680800, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=ho7n/8SOGayMK6ld6bKQ2Q==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=OizfCJzAhjaJVNXpYSsYog==, mapNumber=null, fund=null)}, authors=[Author(id=1323941318795342817, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1323941318887617508, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, authorId=1323941318795342817, language=EN, stringName=Yong-fang SONG, firstName=Yong-fang, middleName=null, lastName=SONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Endocrinology, Affiliated Shenzhen Children’s Hospital of Shantou University Medical College, Shenzhen,Guangdong 518038, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941318950532069, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, authorId=1323941318795342817, language=CN, stringName=宋永芳, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.汕头大学医学院附属深圳儿童医院内分泌科，广东　深圳　518038
2.南方科技大学医院儿科，广东　深圳　518055, bio={"content":"

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Comprehensive Physiology, 2018, 8 (4): 1253-1290., articleTitle=Androgens and the regulation of adiposity and body fat distribution in humans, refAbstract=null), Reference(id=1323941328589041719, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, doi=null, pmid=null, pmcid=null, year=2024, volume=11, issue=5, pageStart=359, pageEnd=369, url=null, language=null, rfNumber=[19], rfOrder=18, authorNames=Borger O, Perl L, Yackobovitch-Gavan M, journalName=LGBT Health, refType=null, unstructuredReference=Borger O, Perl L, Yackobovitch-Gavan M, et al. Body composition and metabolic syndrome components in transgender/gender diverse adolescents and young adults [J]. LGBT Health, 2024, 11 (5): 359-369., articleTitle=Body composition and metabolic syndrome components in transgender/gender diverse adolescents and young adults, refAbstract=null), Reference(id=1323941328681316408, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, doi=null, pmid=null, pmcid=null, year=2022, volume=31, issue=4, pageStart=334, pageEnd=null, url=null, language=null, rfNumber=[20], rfOrder=19, authorNames=Jung HW, Lee J, Kim J, journalName=J Obes Metab Syndr, refType=null, unstructuredReference=Jung HW, Lee J, Kim J. Handgrip strength is associated with metabolic syndrome and insulin resistance in children and adolescents: Analysis of Korea national health and nutrition examination survey 2014-2018 [J]. 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Comparison of demographic characteristics and metabolic indicators between the MetS group and the non-MetS group in children and adolescents of different genders ［M （P25， P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特征
（数据类型）		男童女童
MetS组
（n=92）		非MetS组
（n=1 738）		统计量值P值MetS组
（n=37）		非MetS组
（n=1 405）		统计量值P值
年龄（岁）13.9 (12.2,16.0)13.8 (11.9,15.8)76 544.5000.49113.5 (12.3,15.5)13.7 (11.8,15.4)24 368.5000.516
发育分期（前期/早中期/晚期）6/27/59154/555/1 0291.0870.5940/3/3429/243/1 1332.1880.322
身高（cm）169.9 (159.7, 177.0)166.6 (154.4,172.9)63 854.5000.001161.7 (157.5,167.2)158.4 (152.5,163.2)18 414.0000.002
体重（kg）77.6 (64.0,87.6)54.8 (43.9,64.2)25 743.000<0.00167.9 (59.4,74.6)47.5 (41.4,53.8)4 011.500<0.001
BMI（kg/m2）26.92 (24.23, 29.49)19.53 (17.45,22.24)14 538.500<0.00126.28 (23.65,27.82)18.86 (17.01,20.71)3 295.500<0.001
握力（kg）34.1 (22.1,42.2)29.3 (19.5,37.6)62 414.000<0.00124.3 (19.2,27.2)20.5 (16.4,24.5)1 921.5000.007
腰围（cm）90.0 (83.0,95.4)69.0 (63.0,76.0)11 795.000<0.00182.5 (78.8,89.5)66.0 (61.0,71.1)2 524.000<0.001
收缩压（mm Hg）128.0 (118.3, 136.8)116.0 (108.0,123.0)39 301.000<0.001121.0 (115.0,125.0)107.0 (101.0,113.0)7 453.000<0.001
舒张压（mm Hg）72.0 (68.0,80.0)68.0 (63.0,73.0)50 273.500<0.00175.0 (69.0,79.0)68.0 (63.0,72.0)12 436.000<0.001
血糖（mmol/L）5.55 (5.10,5.78)5.20 (5.00,5.50)57 470.000<0.0015.30 (4.95,5.60)5.10 (4.90,5.30)20 710.0000.034
HDL-C（mmol/L）1.10 (0.97,1.28)1.39 (1.22,1.59)32 018.500<0.0011.21 (1.08,1.39)1.46 (1.29,1.63)12 233.500<0.001
LDL-C（mmol/L）3.04 (2.52,3.57)2.43 (2.13,2.83)43 533.000<0.0013.36 (2.81,3.62)2.57 (2.24,2.94)11 441.500<0.001
甘油三酯（mmol/L）1.52 (1.02,1.94)0.75 (0.61,0.98)23 245.000<0.0011.72 (1.44,2.08)0.84 (0.67,1.06)4 644.500<0.001
), ArticleFig(id=1323941324075970586, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, language=CN, label=表1, caption=

不同性别儿童青少年MetS组与非MetS组人口学特征及代谢指标比较［M（P25，P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特征
（数据类型）		男童女童
MetS组
（n=92）		非MetS组
（n=1 738）		统计量值P值MetS组
（n=37）		非MetS组
（n=1 405）		统计量值P值
年龄（岁）13.9 (12.2,16.0)13.8 (11.9,15.8)76 544.5000.49113.5 (12.3,15.5)13.7 (11.8,15.4)24 368.5000.516
发育分期（前期/早中期/晚期）6/27/59154/555/1 0291.0870.5940/3/3429/243/1 1332.1880.322
身高（cm）169.9 (159.7, 177.0)166.6 (154.4,172.9)63 854.5000.001161.7 (157.5,167.2)158.4 (152.5,163.2)18 414.0000.002
体重（kg）77.6 (64.0,87.6)54.8 (43.9,64.2)25 743.000<0.00167.9 (59.4,74.6)47.5 (41.4,53.8)4 011.500<0.001
BMI（kg/m2）26.92 (24.23, 29.49)19.53 (17.45,22.24)14 538.500<0.00126.28 (23.65,27.82)18.86 (17.01,20.71)3 295.500<0.001
握力（kg）34.1 (22.1,42.2)29.3 (19.5,37.6)62 414.000<0.00124.3 (19.2,27.2)20.5 (16.4,24.5)1 921.5000.007
腰围（cm）90.0 (83.0,95.4)69.0 (63.0,76.0)11 795.000<0.00182.5 (78.8,89.5)66.0 (61.0,71.1)2 524.000<0.001
收缩压（mm Hg）128.0 (118.3, 136.8)116.0 (108.0,123.0)39 301.000<0.001121.0 (115.0,125.0)107.0 (101.0,113.0)7 453.000<0.001
舒张压（mm Hg）72.0 (68.0,80.0)68.0 (63.0,73.0)50 273.500<0.00175.0 (69.0,79.0)68.0 (63.0,72.0)12 436.000<0.001
血糖（mmol/L）5.55 (5.10,5.78)5.20 (5.00,5.50)57 470.000<0.0015.30 (4.95,5.60)5.10 (4.90,5.30)20 710.0000.034
HDL-C（mmol/L）1.10 (0.97,1.28)1.39 (1.22,1.59)32 018.500<0.0011.21 (1.08,1.39)1.46 (1.29,1.63)12 233.500<0.001
LDL-C（mmol/L）3.04 (2.52,3.57)2.43 (2.13,2.83)43 533.000<0.0013.36 (2.81,3.62)2.57 (2.24,2.94)11 441.500<0.001
甘油三酯（mmol/L）1.52 (1.02,1.94)0.75 (0.61,0.98)23 245.000<0.0011.72 (1.44,2.08)0.84 (0.67,1.06)4 644.500<0.001
), ArticleFig(id=1323941324155662363, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, language=EN, label=Table 2, caption=

Metabolic characteristics of study population across different weight-specific handgrip strength (Wt-HGS) categories

, figureFileSmall=null, figureFileBig=null, tableContent=
性别握力等级人数年龄（岁）发育分期（前/早中/晚）握力 (kg)中心性肥胖 (%)高血糖（%）高血压（%）高甘油三酯（%）脂蛋白异常（%）MetS(%)
男童Q150812.6 (11.3,14.5)61/220/22722.3 (16.4,28.4)47.424.411.812.617.19.4
Q241214.0 (12.1,15.8)29/117/26631.3 (21.4,35.6)18.417.016.08.014.36.3
Q344714.4 (12.4,16.3)30/125/29234.6 (21.5,39.9)7.418.117.05.411.62.0
Q446314.4 (12.6,16.1)46/120/30337.4 (23.3,45.3)5.616.415.13.99.91.9
统计值110.49161.084312.855336.68712.416.69930.42612.40939.924
P值<0.001<0.001<0.001<0.0010.0060.082<0.0010.006<0.001
女童Q137113.0 (11.4,15.1)5/67/29916.7 (13.3,19.7)33.710.210.512.712.15.9
Q234813.5 (11.8,15.5)5/60/28320.0 (16.7,22.3)13.28.98.68.010.12.0
Q334314.2 (12.2,15.5)5/51/28722.5 (19.6,25.2)11.412.29.97.610.52.0
Q438013.9 (12.2,15.8)14/68/29825.5 (19.6,28.8)7.611.89.25.07.60.3
统计值25.8413.681383.854110.0812.5870.84614.9554.30325.642
P值<0.0010.298<0.001<0.0010.4610.8390.0020.231<0.001
), ArticleFig(id=1323941324264714268, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, language=CN, label=表2, caption=

不同Wt-HGS等级研究对象的代谢指标特征

, figureFileSmall=null, figureFileBig=null, tableContent=
性别握力等级人数年龄（岁）发育分期（前/早中/晚）握力 (kg)中心性肥胖 (%)高血糖（%）高血压（%）高甘油三酯（%）脂蛋白异常（%）MetS(%)
男童Q150812.6 (11.3,14.5)61/220/22722.3 (16.4,28.4)47.424.411.812.617.19.4
Q241214.0 (12.1,15.8)29/117/26631.3 (21.4,35.6)18.417.016.08.014.36.3
Q344714.4 (12.4,16.3)30/125/29234.6 (21.5,39.9)7.418.117.05.411.62.0
Q446314.4 (12.6,16.1)46/120/30337.4 (23.3,45.3)5.616.415.13.99.91.9
统计值110.49161.084312.855336.68712.416.69930.42612.40939.924
P值<0.001<0.001<0.001<0.0010.0060.082<0.0010.006<0.001
女童Q137113.0 (11.4,15.1)5/67/29916.7 (13.3,19.7)33.710.210.512.712.15.9
Q234813.5 (11.8,15.5)5/60/28320.0 (16.7,22.3)13.28.98.68.010.12.0
Q334314.2 (12.2,15.5)5/51/28722.5 (19.6,25.2)11.412.29.97.610.52.0
Q438013.9 (12.2,15.8)14/68/29825.5 (19.6,28.8)7.611.89.25.07.60.3
统计值25.8413.681383.854110.0812.5870.84614.9554.30325.642
P值<0.0010.298<0.001<0.0010.4610.8390.0020.231<0.001
), ArticleFig(id=1323941324386349085, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, language=EN, label=Table 3, caption=

Association analysis between weight-specific handgrip strength (Wt-HGS) categories and metabolic syndrome risk [OR (95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
模型男童Wt-HGS 四分位区间女童Wt-HGS 四分位区间
Q1Q2Q3Q4Q1Q2Q3Q4
模型一5.26 (2.55～10.85)***3.40 (1.57～7.34)**1.04 (0.41～2.64)1.0011.91 (2.78～51.04)**3.38 (0.80～18.80)3.94 (0.81～19.08)1.00
模型二6.13 (2.94～12.81)***3.54 (1.64～7.65)**1.04 (0.41～2.63)1.0012.90 (3.00～55.54)**3.98 (0.82～19.29)3.93 (0.81～19.07)1.00
模型三5.74 (2.77～11.90)***3.40 (1.57～7.35)**1.03 (0.41～2.63)1.0011.66 (2.72～50.00)**3.77 (0.78～18.27)3.76 (0.78～18.25)1.00
模型四6.10 (2.92～12.75)***3.51 (1.62～7.59)**1.03 (0.41～2.63)1.0012.09 (2.80～52.19)**3.82 (0.79～18.55)3.79 (0.78～18.37)1.00
), ArticleFig(id=1323941324474429470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941314928194512, language=CN, label=表3, caption=

Wt-HGS等级与MetS患病风险的关联分析[OR (95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
模型男童Wt-HGS 四分位区间女童Wt-HGS 四分位区间
Q1Q2Q3Q4Q1Q2Q3Q4
模型一5.26 (2.55～10.85)***3.40 (1.57～7.34)**1.04 (0.41～2.64)1.0011.91 (2.78～51.04)**3.38 (0.80～18.80)3.94 (0.81～19.08)1.00
模型二6.13 (2.94～12.81)***3.54 (1.64～7.65)**1.04 (0.41～2.63)1.0012.90 (3.00～55.54)**3.98 (0.82～19.29)3.93 (0.81～19.07)1.00
模型三5.74 (2.77～11.90)***3.40 (1.57～7.35)**1.03 (0.41～2.63)1.0011.66 (2.72～50.00)**3.77 (0.78～18.27)3.76 (0.78～18.25)1.00
模型四6.10 (2.92～12.75)***3.51 (1.62～7.59)**1.03 (0.41～2.63)1.0012.09 (2.80～52.19)**3.82 (0.79～18.55)3.79 (0.78～18.37)1.00
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儿童青少年体重别握力与代谢综合征的关联性分析
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宋永芳 1, 2 , 李卓光 1 , 郑荣飞 1 , 赵岫 1 , 吴楚姗 1 , 肖润廷 1 , 苏琪茹 3 , 熊静帆 4 , 苏喆 1
现代预防医学 | 儿少卫生与妇幼保健 2025,52(23): 4310-4314
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现代预防医学 |儿少卫生与妇幼保健 2025 , 52 (23) : 4310 -4314
儿童青少年体重别握力与代谢综合征的关联性分析
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宋永芳1, 2, 李卓光1, 郑荣飞1, 赵岫1, 吴楚姗1, 肖润廷1, 苏琪茹3, 熊静帆4, 苏喆1
作者信息
  • 1.汕头大学医学院附属深圳儿童医院内分泌科，广东　深圳　518038
  • 2.南方科技大学医院儿科，广东　深圳　518055
  • 3.深圳儿童医院临床研究室
  • 4.深圳市慢性病防治中心
通讯作者:
苏喆，E-mail：
作者简介:

宋永芳与李卓光为共同第一作者

宋永芳（1983—），女，硕士，副主任医师，研究方向：儿童内分泌疾病；

李卓光（1993—），男，博士，主治医师，研究方向：儿童内分泌遗传罕见病；

Association between weight-specific handgrip strength and metabolic syndrome in children and adolescents
Yong-fang SONG1, 2, Zhuo-guang LI1, Rong-fei ZHENG1, Xiu ZHAO1, Chu-shan WU1, Run-ting XIAO1, Qi-ru SU3, Jing-fan XIONG4, Zhe SU1
Affiliations
  • Department of Endocrinology, Affiliated Shenzhen Children’s Hospital of Shantou University Medical College, Shenzhen,Guangdong 518038, China
出版时间: 2025-12-10 doi: 10.20043/j.cnki.MPM.202501232
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摘要
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目的

探讨体重别握力（weight-specific handgrip strength, Wt-HGS）与代谢综合征（metabolic syndrome, MetS）及其组分的关系，为儿童青少年代谢风险评估提供新的依据。

方法

数据来源于2021年深圳市中小学生营养健康与生长发育评估与监测项目。依据握力百分位参考标准，将握力按年龄别握力（age-specific handgrip strength, Age-HGS）和Wt-HGS分为四分位（Q1～Q4），其中Q1定义为低握力组。比较两种标准下低握力儿童的MetS及其组分患病率差异。

结果

研究共纳入3 272名10～18岁儿童青少年，中位年龄为13.8（11.9,15.6）岁，MetS患病率为3.9%（n=129）。基于Wt-HGS标准划分的低握力组，其MetS患病率显著高于Age-HGS标准组（男童9.4% vs. 2.6%；女童5.9% vs. 1.4%）。Logistic回归分析显示，以Wt-HGS最高四分位（Q4）为参照，男童Q1组的MetS患病风险显著增加（OR=5.26，95% CI: 2.55～10.85），女童风险更高（OR=11.91，95% CI: 2.78～51.04）；在调整年龄、青春发育分期等潜在混杂因素后，该关联仍显著存在。

结论

较低的Wt-HGS水平可能是儿童青少年MetS的危险因素，提示加强肌力评估与干预措施，可能有助于MetS的早期防控。

儿童青少年  /  握力  /  体重  /  代谢综合征  /  横断面研究
Objective

To explore the relationship between weight-specific handgrip strength (Wt-HGS) and metabolic syndrome(MetS) and its components, providing new evidence for metabolic risk assessment in children and adolescents.

Methods

Data were derived from the 2021 Evaluation and Monitoring of School-based Nutrition and Growth in Shenzhen (EMSNGS) study. Based on handgrip strength percentile reference standards, handgrip strength was categorized into quartiles (Q1-Q4) using both age-specific(Age-HGS) and weight-specific (Wt-HGS) percentiles, with Q1 defined as the low handgrip strength group. The prevalence of MetS and its components was compared between the low handgrip strength groups based on the two standards.

Results

A total of 3 272 children and adolescents aged 10-18 years were included in the study, with a median age of 13.8 (11.9, 15.6) years and a MetS prevalence of 3.9% (n=129). The prevalence of MetS was significantly higher in the low handgrip strength group defined by Wt-HGS than in that defined by Age-HGS (boys: 9.4% vs 2.6%; girls: 5.9% vs 1.4%). Logistic regression analysis revealed that, compared to the highest quartile of Wt-HGS (Q4), the odds ratio (OR) for MetS risk in boys in the Q1 group was 5.26 (95% CI: 2.55-10.85), and for girls, the risk was even higher (OR=11.91, 95% CI: 2.78-51.04). After adjusting for age, puberty stage, and other potential confounders, the association remained statistically significant.

Conclusion

Lower Wt-HGS may be a risk factor for MetS in children and adolescents, highlighting the potential value of muscle strength assessment and targeted interventions in the early prevention and control of MetS.

Children and adolescents  /  Handgrip strength  /  Weight  /  Metabolic syndrome  /  Cross-sectional study
宋永芳, 李卓光, 郑荣飞, 赵岫, 吴楚姗, 肖润廷, 苏琪茹, 熊静帆, 苏喆. 儿童青少年体重别握力与代谢综合征的关联性分析. 现代预防医学, 2025 , 52 (23) : 4310 -4314 . DOI: 10.20043/j.cnki.MPM.202501232
Yong-fang SONG, Zhuo-guang LI, Rong-fei ZHENG, Xiu ZHAO, Chu-shan WU, Run-ting XIAO, Qi-ru SU, Jing-fan XIONG, Zhe SU. Association between weight-specific handgrip strength and metabolic syndrome in children and adolescents[J]. Modern Preventive Medicine, 2025 , 52 (23) : 4310 -4314 . DOI: 10.20043/j.cnki.MPM.202501232
正文
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代谢综合征（metabolic syndrome, MetS）是一组以中心性肥胖、高血压、高血糖和血脂异常为主要特征的代谢紊乱状态，是2型糖尿病和心脑血管疾病的重要危险因素[1-2]。2020年，全球儿童和青少年MetS患病率分别为2.8%和4.8%，中国分别为2.3%和2.9%，已成为亟需关注的公共卫生问题[3]。尽管成人研究已证实骨骼肌功能与代谢健康密切相关，但生长发育期人群中尚存争议[4-5]。握力作为肌肉力量的重要指标，受体型与发育差异影响，因缺乏统一的标准化方法，其与代谢结局的关联结果不一致[6-8]。现有的标准化方法易受到体成分差异的影响，导致反向偏倚。为克服上述问题，我们团队在建立中国6～18岁握力参考体系时，创新性提出了“体重别握力”（weight-specific handgrip strength, Wt-HGS）的概念，通过按体重分组绘制握力百分位曲线，实现体型同质化评估，更准确地反映肌力与体重的生理关系[9]。本研究基于该体系，探讨Wt-HGS与MetS及其组分的关联，为儿童青少年代谢风险的早期识别提供参考依据。
1　对象与方法
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1.1　调查对象
本研究纳入2021年10—12月参与深圳市中小学生营养健康与生长发育评估与监测（Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen，EMSNGS）项目基线调查的儿童青少年。该项目采用多阶段分层整群随机抽样，从深圳市10个行政区各随机抽取1所小学、初中和高中（共27所，含3所九年一贯制学校），再从每个年级中随机抽取1个班级进行调查。所有研究对象均在知情和自愿的基础上参与。本项目获得了深圳市儿童医院医学伦理委员会（审批号：SCH2021105）和深圳市慢性病防治中心伦理委员会（审批号：SZCC-2021-037-01-PJ）的批准，并在中国临床试验注册中心登记（登记号：ChiCTR2100051722）。
纳入标准为年龄10～18岁的调查对象。排除标准：（1）研究相关的关键信息缺失；（2）无法配合禁食要求；（3）存在可能影响生长发育的慢性疾病，如骨发育异常、内分泌疾病（生长激素缺乏症、甲状腺疾病、青春发育异常等）、血液系统疾病、慢性肝肾疾病等；（4）长期使用生长激素、糖皮质激素或免疫抑制剂等药物；（5）近期患有急性疾病。
样本量估算：计算公式如下，。其中置信水平取95%（双侧），对应μ值为1.96；p取2020年中国青少年MetS患病率2.9%；相对误差r为20%，则d=r×p。设计效应（deff）取值为1.2，估算所需样本量约为2 840人。考虑到预期应答率为90%，最终所需样本量约为：2 840 / 0.9 ≈ 3 156人。
1.2　方法
（1）问卷调查：基本信息、人口学特征、生活方式、疾病史和用药史等。（2）体格测量：按照《学生健康检查技术规范》（GB/T 26343—2010）的要求。身体质量指数（body mass index, BMI）计算公式为体重（kg）除以身高的二次方（m2）。（3）握力测量及标准化：用电子握力计（Jamar Plus+）测量，参照团队前期建立的中国儿童青少年握力百分位参考标准[9]，按年龄别握力（age-specific handgrip strength，Age-HGS）和体重别握力（Wt-HGS）划分为四分位等级（Q1～Q4）。（4）青春发育评估：按Tanner分期，I期为前期， II或III期为早中期， IV或V期为晚期。（5）代谢指标检测：早晨空腹采血检测空腹血糖（fasting blood glucose, FBG）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol, HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol, LDL-C）、甘油三酯（triglycerides）等指标。
1.3　MetS诊断标准
根据中华医学会儿科分会发布的《中国儿童青少年代谢综合征定义和防治建议》[10]，≥10岁儿童青少年MetS的诊断标准如下，中心性肥胖（腰围≥同性别同年龄儿童腰围的第90百分位）作为基本和必备条件，同时满足以下任意两项：（1）高血糖：空腹血糖受损（FBG≥5.6 mmol/L）、糖耐量受损，或已确诊为2型糖尿病；（2）高血压：收缩压（systolic blood pressure）或舒张压（diastolic blood pressure）≥ 同年龄同性别儿童血压的第95百分位；（3）脂蛋白异常：HDL-C<1.03 mmol/L或LDL-C≥3.76 mmol/L。（4）高甘油三酯≥1.47 mmol/L。
1.4　统计学分析
使用SPSS 25.0软件进行统计分析。正态分布的连续性变量以表示，组间比较采用独立样本t检验（方差齐时）或校正t检验（方差不齐时）。非正态分布连续性变量以［M（P25，P75）］表示，组间比较采用非参数检验，两两比较采用Mann-Whitney U检验，多组间比较采用Kruskal-Wallis H检验。分类变量以百分比（%）表示，组间比较采用χ2检验或Fisher确切概率法。采用二元logistic回归模型评估不同Wt-HGS分位等级与MetS及其组分之间的关联。所有统计检验均为双侧检验，检验水准α=0.05。
2　结果
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2.1　研究对象基本特征
本研究最终纳入3 272名儿童青少年，其中男童1 830人，女童1 442人；年龄范围为10～18岁，中位年龄为13.8（11.9,15.6）岁。本研究中确诊为MetS者共129人，总患病率为3.9%；其中男童MetS患病人数为92人（5.0%），女童为37人（2.6%）。对于男童，MetS组与非MetS组的指标比较显示：MetS组的身高、体重、BMI、握力、腰围、收缩压、舒张压、LDL-C及甘油三酯水平均高于非MetS组，HDL-C水平则低于非MetS组，差异均有统计学意义（P<0.05）。女童中上述指标的组间差异规律与男童一致。不同性别儿童青少年MetS组与非MetS组人口学特征及代谢指标比较见表1。
2.2　基于Age-HGS和Wt-HGS划分的低握力儿童在MetS及其组分患病率的比较
依据握力百分位参考标准，握力数据按Age-HGS和Wt-HGS分为四分位等级（Q1～Q4），其中最低四分位（Q1）被定义为低握力组。图1展示了Age-HGS和Wt-HGS低握力组（Q1）在MetS及其各组分上的患病率差异。结果表明，Wt-HGS低握力男童的MetS（9.4% vs. 2.6%）及其组分中心性肥胖（47.4% vs. 15.1%）、高血糖（24.4%vs. 18.5%）、高甘油三酯（12.6% vs. 7.3%）和脂蛋白异常（17.1% vs. 12.3%）的患病率均显著高于Age-HGS低握力男童（P<0.05）。同样，Wt-HGS低握力女童在MetS（5.9% vs. 1.4%）及其组分中心性肥胖（33.7% vs.8.9%）和高甘油三酯（12.7% vs. 6.6%）的患病率也显著高于Age-HGS低握力女童（P<0.05）。
2.3　不同Wt-HGS等级儿童青少年的代谢特征
握力数据按照Wt-HGS四分位等级（Q1～Q4）进行划分。男童Q1～Q4等级的人数分别为508、412、447和463人，女童分别为371、348、343和380人。分析结果表明，与低握力组相比，男女童的Wt-HGS等级越高，MetS患病率越低（P<0.05）。同时，男女童的中心性肥胖、高甘油三酯的患病率也随Wt-HGS等级的提高而降低（P<0.05）。然而，高血糖、脂蛋白异常的患病率仅在男童中与Wt-HGS等级呈负向关联（P<0.05），而高血压的患病率在男女童中均未观察到与Wt-HGS等级的统计学关联（P>0.05）。见表2。
2.4　Wt-HGS与MetS及其组分患病风险的关联分析
以Wt-HGS最高四分位等级（即Q4）为参照，采用二元logistic回归模型评估不同Wt-HGS等级与MetS及其组分之间的关联，见表3。回归分析中，我们采用年龄、青春发育分期进行了混杂因素校正。结果显示，Wt-HGS等级的降低与男女童MetS患病风险的显著升高相关。以Q4组为参照，男童在Q2和Q1组的MetS患病风险分别显著升高，其比值比（odds ratio, OR）分别为3.40（95% CI: 1.57～7.34）和5.26（95% CI: 2.55～10.85）；女童在Q1组的OR为11.91（95% CI: 2.78～51.04）。也就是说，处于Wt-HGS最低四分位（Q1）的儿童在两性中均表现出显著较高的MetS患病风险。该关联在校正年龄和青春期发育分期等混杂因素后仍然成立。
3　讨论
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本研究首次采用团队已建立的中国深圳地区10～18岁青少年Wt-HGS参考标准，对握力进行标准化处理[9]，并探讨其与MetS之间的关联；同时，将其与Age-HGS进行对比，旨在为 MetS 的早期筛查提供一种直观且可行的评估方法。研究结果显示，10～18岁青少年中 MetS 的总体患病率为 3.9%，且存在显著性别差异，男童（5.0%）显著高于女童（2.6%），这与多项既往研究结果一致[3,11-12]。令人担忧的是，已有纵向研究表明儿童期MetS可持续至成年，并增加心血管疾病及 2 型糖尿病的风险[13-14]。因此，早期识别和干预儿童MetS至关重要。
握力作为衡量肌肉力量的常用指标，近年来已被证实与代谢健康密切相关[6,15-16]。尽管握力与体重的比值（HGS/Wt）已被纳入青少年肌力评估的参考标准之一[6,17]，但该指标存在局限性。一是，儿童握力与体重的关系受肌肉/脂肪比例动态调节，且无法区分体重中的肌肉与脂肪等成分，可能掩盖体成分异质性对握力的真实影响；二是，现有研究多聚焦中老年或特定疾病人群，缺乏发育期人群的证据。本研究提出通过按体重四分位分组构建Wt-HGS代谢风险分层框架，具有以下优势：更敏感地识别高风险人群（如最低四分位组，男童和女童的MetS风险OR分别为5.26和11.91）；与成人研究互补，揭示青少年肌肉与代谢健康的普适关联规律；基于握力百分位曲线实现标准化评估，为代谢可塑性关键期的风险识别提供精准工具。
本研究与团队近期的EMSNGS研究[9]共同证实，Wt-HGS在识别MetS风险方面明显优于Age-HGS。例如，本研究中，Wt-HGS低握力组男童的MetS患病率为9.4%，而Age-HGS低握力组为2.6%；在女童中，该差异同样具有统计学意义（5.9% vs. 1.4%）。EMSNGS研究[9]通过GAMLSS模型建立了中国儿童体重特异性握力参考值，并发现Wt-HGS低握力组的CMRI z评分（心脏代谢风险指数）显著高于年龄调整组，尤其在男童中，剂量-反应关系更为显著。这一结果的生理学基础在于，握力需对抗自身体重负荷，Wt-HGS更能反映肌肉功能与代谢需求之间的动态平衡。此外，男女童低Wt-HGS组的MetS风险显著不同，这一性别差异与已有研究揭示的肌肉代谢性别特异性机制一致[18-19]，提示在MetS防控中应结合性别差异制定更精准的握力评估标准和干预策略。
本研究发现，较低的Wt-HGS水平可能是儿童青少年MetS的潜在危险因素。通过按体重分层，Wt-HGS能够有效校正体型偏倚，特别适用于肥胖或营养不良等极端体型群体。作为一种简便且无创的肌力评估工具，Wt-HGS可在学校健康筛查中广泛应用，为MetS的早期识别提供有力支持。此外，研究结果还支持将肌力训练纳入儿童青少年的代谢健康干预策略，尤其是针对低握力个体的精准干预[6,20]。本研究的局限性包括：首先，作为横断面研究，仅能揭示握力与MetS之间的相关性，尚需前瞻性研究验证因果关系；其次，部分潜在影响因素如睡眠、饮食及体育活动水平未被纳入，可能影响结果的全面性；最后，研究对象局限于深圳地区青少年，可能限制外部推广性。
综上所述，本研究证实Wt-HGS是儿童青少年MetS的独立风险标志，其评估效果优于传统的年龄别标准。建议在公共卫生实践中推广体重标准化握力测评，并结合早期肌力干预，以降低代谢异常风险，为慢性病防控前移提供科学依据。
基金
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  • 国家自然科学基金(82501063)
  • 广东省卫生健康委员会高水平临床重点专科（深圳市配套建设经费）项目(SZGSP012)
  • 广东省高水平医院建设经费深圳市儿童医院临床研究专项课题(LCYJ2022088)
  • 广东省基础与应用基础研究基金(2023A1515110354)
  • 广东省高水平医院财政资金(ynkt2022-zz15)
  • 深圳市“医疗卫生三名工程”项目资助(SZSM202411011)
文献
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参考文献 引证文献
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2025年第52卷第23期
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doi: 10.20043/j.cnki.MPM.202501232
  • 接收时间：2025-01-13
  • 首发时间：2026-11-02
  • 出版时间：2025-12-10
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  • 收稿日期：2025-01-13
基金
国家自然科学基金(82501063)
广东省卫生健康委员会高水平临床重点专科（深圳市配套建设经费）项目(SZGSP012)
广东省高水平医院建设经费深圳市儿童医院临床研究专项课题(LCYJ2022088)
广东省基础与应用基础研究基金(2023A1515110354)
广东省高水平医院财政资金(ynkt2022-zz15)
深圳市“医疗卫生三名工程”项目资助(SZSM202411011)
作者信息
    1.汕头大学医学院附属深圳儿童医院内分泌科，广东　深圳　518038
    2.南方科技大学医院儿科，广东　深圳　518055
    3.深圳儿童医院临床研究室
    4.深圳市慢性病防治中心

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